BackgroundThe acceptance of transvaginal ultrasound among Brazilian pregnant women is not yet established.ObjectiveTo evaluate the level of acceptance of transvaginal ultrasound (US) among high risk pregnant women.MethodPsychological semi structured interview with 50 pregnant patients scheduled to undergo ultrasound exam.Results94% of the patients arrive without knowing they are going to undergo a transvaginal US and 80% believe they are going to undergo a regular abdominal US. Asked about the utility of transvaginal US, 46% didn't know; 70% didn't have any preferences about the sex of the ultrasonographist. After the exam, 76% of the patients referred no particular discomfort, but 46% would prefer to have an abdominal US scan if they could choose, but all emphasized they would undergo the exam again if the doctor said it was necessary. As far as sexuality, 12% mentioned some difficulty with the partner and 40% referred that it is hard for women to discuss subjects related to sex.ConclusionThe discomfort eventually associated to transvaginal US is not related to the sex of the examiner but to his attitude. Patients' fantasies play an important role in the emotional discomfort elicited by the situation where cultural aspects are deeply imbricated.